Effects of Parathyroid Hormone on Immune Function

Geara, Abdallah S.; Castellanos, Mario R.; Bassil, Claude; Schuller‐Levis, Georgia; Park, Eunkue; Smith, Marianne; Goldman, Melvin; El‐Sayegh, Suzanne

doi:10.1155/2010/418695

Cited by 49 publications

(41 citation statements)

References 76 publications

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“…Increases in intracellular calcium levels potentially lead to an increase in cellular adenylate cyclase activity; this has been proposed as the mechanism by which PTH influences leukocytes. However, the effects of PTH on T lymphocytes are neither consistent nor conclusive (Geara et al 2010). Most studies showed that PTH exerts an inhibitory effect on various immune system parameters, while other studies showed that PTH has a stimulatory function.…”

Section: Discussionmentioning

confidence: 94%

“…There is a direct correlation between PTH levels in uremic patients and the degree of lymphocyte proliferation inhibition in ESRD patients with SHP; PTH has been identified as a possible factor in the development of an acquired immune dysfunction (ShurtzSwirski et al 1995). PTH receptors are found on most immunologic cells (neutrophils, B cells, and T cells), suggesting a potential role for PTH in immune system regulation (Geara et al 2010). Increases in intracellular calcium levels potentially lead to an increase in cellular adenylate cyclase activity; this has been proposed as the mechanism by which PTH influences leukocytes.…”

Section: Discussionmentioning

confidence: 99%

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Calcitriol Treatment Attenuates Inflammation and Oxidative Stress in Hemodialysis Patients with Secondary Hyperparathyroidism

Chang

Chen

et al. 2011

Tohoku J. Exp. Med.

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Hemodialysis patients with secondary hyperparathyroidism (SHP) suffer from excessive oxidative stress and inflammation. Vitamin D analogues are currently the first line therapy for SHP, but the influence of vitamin D treatment on inflammation and oxidative stress remains unknown. This study investigated the influence of vitamin D therapy on oxidative stress and inflammatory markers in hemodialysis patients with SHP. Twenty-five patients (mean age 58 ± 12 years, 13 males and 12 females) were enrolled in the study to receive calcitriol treatment for 16 weeks. We evaluated changes in the serum biochemical parameters, inflammatory markers [C-reactive protein (CRP) and interleukin-6 (IL-6) levels], serum oxidative stress condition [total antioxidant status (TAS)], and CD4 + T-lymphocyte intracellular cytokines [interferon γ (IFN-γ) and interleukin-4 (IL-4)] before and at the end of the 16-week calcitriol treatment. Correlations between each of these factors were also studied. All patients with SHP had low serum 1,25-dihydroxyvitamin D 3 levels and elevated serum levels of intact parathyroid hormone (iPTH), CRP and IL-6. Twenty patients (10 males and 10 females) responded to the calcitriol therapy, with significant decrements in serum iPTH. Our results showed that calcitriol can effectively suppress iPTH secretion, reduce inflammatory markers (CRP and IL-6) and oxidative stress. It can also effectively reduce inflammatory cytokine (CD4 + IFN-γ) and increase anti-inflammatory cytokine (CD4 + IL-4). Interestingly, significant correlations between CD4 + IFN-γ levels and serum iPTH levels, as well as between TAS and iPTH levels were noted. Overall, our study has demonstrated calcitriol treatment significantly attenuates inflammation and oxidative stress in hemodialysis patients with SHP.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Calcitriol Treatment Attenuates Inflammation and Oxidative Stress in Hemodialysis Patients with Secondary Hyperparathyroidism

Chang

Chen

et al. 2011

Tohoku J. Exp. Med.

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“…Correlations between VZV immunoglobulin and mineral bone parameters were analyzed owing to anecdotal evidence regarding the impact of hyperparathyroidism on immune system, and calcium related VZV gene regulation2223. VZV-IgG levels were negatively associated with the presence of malignancy ( p = 0.02), marginally associated with male gender ( p = 0.06), whereas VZV-IgM levels were positively associated with higher hemoglobin levels ( p = 0.05) but negatively associated with the presence of heart failure in chronic dialysis patients ( p = 0.04).…”

Section: Resultsmentioning

confidence: 99%

Serum vitamin D levels are positively associated with varicella zoster immunity in chronic dialysis patients

Chao

Lee

Yang

et al. 2014

Sci Rep

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Uremia results in a relatively immunocompromised status, and patients under chronic dialysis have an elevated risk of developing herpes zoster (HZ). We sought to investigate the relationship between vitamin D status and immunity to varicella-zoster virus (VZV). A multicenter prevalent hemodialysis cohort was assembled between 2012 and 2013. We assayed the biochemical parameters, 25-hydroxy- (25-OH-D) and 1,25-dihydroxyvitamin D, vitamin D-binding protein levels in the sera. VZV immunity was quantitated using VZV-specific glycoprotein IgG and IgM titers. Eighty-eight patients were enrolled and their sera were analyzed. Chronic hemodialysis patients with 25-OH-D < 30 ng/ml (insufficiency or deficiency) had significantly lower VZV-IgG than those with sufficient 25-OH-D (p = 0.04). This discrepancy became more prominent if active vitamin D users alone were analyzed (p = 0.01). Generalized additive modeling showed that those with 25-OH-D higher than 27.8 ng/ml or bioavailable 25-OH-D higher than 3.88 ng/ml had significantly higher VZV-IgG levels than those with lower values. Linear regression suggested that both total and bioavailable 25-OH-D were significantly associated with higher VZV-IgG levels (p = 0.003 [total] and 0.01 [bioavailable]), whereas patients with cancer had lower VZV-IgG. Vitamin D may therefore be a potentially useful choice for raising VZV immunity in chronic dialysis patients.

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“…dysfunction. 133,134 Furthermore, a very recent study showed that in 5/6 nephrectomized mice, PTH induced adipose tissue browning and cachexia and, thereby, presumably induced skeletal muscle atrophy. 135 Thus, there are multiple mechanisms linking the physiological response for maintaining phosphate homeostasis with adverse clinical outcomes.…”

Section: Toxicity Of Excess Phosphatementioning

confidence: 99%

Phosphate—a poison for humans?

Komaba

Fukagawa

2016

Kidney International

112

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Maintenance of phosphate balance is essential for life, and mammals have developed a sophisticated system to regulate phosphate homeostasis over the course of evolution. However, due to the dependence of phosphate elimination on the kidney, humans with decreased kidney function are likely to be in a positive phosphate balance. Phosphate excess has been well recognized as a critical factor in the pathogenesis of mineral and bone disorders associated with chronic kidney disease, but recent investigations have also uncovered toxic effects of phosphate on the cardiovascular system and the aging process. Compelling evidence also suggests that increased fibroblastic growth factor 23 and parathyroid hormone levels in response to a positive phosphate balance contribute to adverse clinical outcomes. These insights support the current practice of managing serum phosphate in patients with advanced chronic kidney disease, although definitive evidence of these effects is lacking. Given the potential toxicity of excess phosphate, the general population may also be viewed as a target for phosphate management. However, the widespread implementation of dietary phosphate intervention in the general population may not be warranted due to the limited impact of increased phosphate intake on mineral metabolism and clinical outcomes. Nonetheless, the increasing incidence of kidney disease or injury in our aging society emphasizes the potential importance of this issue. Further work is needed to more completely characterize phosphate toxicity and to establish the optimal therapeutic strategy for managing phosphate in patients with chronic kidney disease and in the general population.

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Effects of Parathyroid Hormone on Immune Function

Cited by 49 publications

References 76 publications

Calcitriol Treatment Attenuates Inflammation and Oxidative Stress in Hemodialysis Patients with Secondary Hyperparathyroidism

Calcitriol Treatment Attenuates Inflammation and Oxidative Stress in Hemodialysis Patients with Secondary Hyperparathyroidism

Serum vitamin D levels are positively associated with varicella zoster immunity in chronic dialysis patients

Phosphate—a poison for humans?

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